Healthcare Provider Details

I. General information

NPI: 1831954551
Provider Name (Legal Business Name): SACRED HEART HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 N STATE ROAD 7 STE 409B
LAUDERDALE LAKES FL
33319-4882
US

IV. Provider business mailing address

4000 N STATE ROAD 7 STE 409B
LAUDERDALE LAKES FL
33319-4882
US

V. Phone/Fax

Practice location:
  • Phone: 954-348-2430
  • Fax:
Mailing address:
  • Phone: 954-348-2430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE BLAKE
Title or Position: OWNER
Credential:
Phone: 945-348-2430